Does statin-treated hyperlipidemia affect rotator cuff healing or muscle fatty infiltration after rotator cuff repair?

Amit, Priyadarshi; Kuiper, Jan Herman; James, Steven; Snow, Martyn

doi:10.1016/j.jse.2021.05.014

Cited by 12 publications

(26 citation statements)

References 41 publications

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“…14 On the other hand, it has recently been suggested that hyperlipidemia alone may not be a risk factor for retear after rotator cuff surgery. 3,23 In the present study, similar to Ishitani et al, 17 no association was found between Goutallier classification, hyperlipidemia, or tear size and stump classification. In our opinion, stump classification is an assessment of rotator cuff tendon quality, and excessive traction on a degenerated rotator cuff due to fatty degeneration may lead to retear.…”

Section: Discussionsupporting

confidence: 88%

“…20,26 Fatty degeneration of muscles, as represented by the Goutallier classification, and tear size are important risk factors for retear after rotator cuff tear surgery. 39 Hyperlipidemia is reported to be involved in the progression of Goutallier classification 3 and is considered a risk for retear after rotator cuff surgery. 14 On the other hand, it has recently been suggested that hyperlipidemia alone may not be a risk factor for retear after rotator cuff surgery.…”

Section: Discussionmentioning

confidence: 99%

“…11 Hyperlipidemia was determined by whether oral statins were prescribed. 3 Based on the Cofield classification, rotator cuff tear size was defined as small tears (<1 cm), medium tears (1-3 cm), large tears (3-5 cm), and massive tears (>5 cm). 10 Fatty degeneration was defined regarding the Goutallier classification, 15 with grade 0 indicating no fatty infiltration; grade 1, some fatty streaks in the supraspinatus; grade 2, less fat than muscle; grade 3, equal amounts of fat and muscle; and grade 4, more fat than muscle.…”

Section: Methodsmentioning

confidence: 99%

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Biochemical Markers of Aging (Advanced Glycation End Products) and Degeneration Are Increased in Type 3 Rotator Cuff Tendon Stumps With Increased Signal Intensity Changes on MRI

et al. 2022

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Background: Advanced glycation end products (AGEs) are end products of protein glycation that bind to the receptor for AGEs (RAGE) and activate nicotinamide adenine dinucleotide phosphate oxidase (NOX), resulting in increased oxidative stress and rotator cuff fragility. Stump classification using the signal intensity ratio of the tendon rupture site to the deltoid muscle in the coronal view of T2-weighted fat-suppressed magnetic resonance imaging (MRI) scans is an indicator of clinical outcomes after rotator cuff repair surgery. Comparing the signal intensities of the deltoid (D) and rotator cuff tears (C), Ishitani et al. classified C/D <0.8 as type 1, 0.8 to 1.3 as type 2, and >1.3 as type 3. Hypothesis/Purpose: It was hypothesized that the oxidative stress and collagen degeneration that occur in the rotator cuff due to accumulation of AGEs can be assessed on MRI scans (stump classification). Therefore, this study aimed to compare AGE-related factors in the rotator cuff tear site tissues based on stump classification. Study Design: Descriptive laboratory study. Methods: The authors included 30 patients (11 with type 1, 9 with type 2, and 10 with type 3; mean age, 62.3 years) who underwent surgery for complete rotator cuff tears at our hospital. Tendon tissue was harvested from the torn rotator cuff site during surgery for tissue and cell evaluation. Results: There was no significant difference in the mean age according to stump classification. The number of patients with diabetes was significantly larger in type 3 than in the other types ( P < .05). Tissue evaluation showed significantly higher expression of AGE and RAGE staining in type 3 than in the other types (~6.7-fold; P < .01). Cell evaluation showed that the expression rates of reactive oxygen species and apoptosis were significantly higher in type 3 than in the other types (~4.3-fold; P < .01). Gene expression by real-time polymerase chain reaction showed significantly higher RAGE (~5.1-fold), NOX (~5.3-fold), and IL (~3.0-fold) in type 3 than in the other types ( P < .05). Conclusion: Stump classification type 3 exhibited the highest accumulation of AGEs and the highest oxidative stress and apoptosis, suggesting a high degree of degeneration and inflammation. Imaging based on stump classification reflects the degeneration and fragility of the torn rotator cuff site. Clinical Relevance: This study provides evidence of a relationship between stump classification, which reflects rotator cuff fragility on MRI, and pathologies related to advanced glycation end products.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Biochemical Markers of Aging (Advanced Glycation End Products) and Degeneration Are Increased in Type 3 Rotator Cuff Tendon Stumps With Increased Signal Intensity Changes on MRI

et al. 2022

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“…In 5 of 5 studies 4,8,23,38,61 recording functional outcomes, there was no significant difference in DLD patients versus non-DLD patients across multiple outcome measures and patient-reported assessments (Table II). Function was recorded postoperatively at 3, 6, 25 12 4,8 , and 24 months.…”

Section: Functionmentioning

confidence: 99%

“…Meta-analysis was performed with results from 7 studies 4,23,25,30,31,46,49 reporting retear among DLD patients; Cancienne et al 11 were excluded because of patient overlap with O'Donnell et al 46 In total, 42,402 subjects were included, 52.8% of which had DLD. Patient age ranged from 45.3 to 84 years, with 54.0% males.…”

Section: Retearmentioning

confidence: 99%

Dyslipidemia is associated with risk for rotator cuff repair failure: a systematic review and meta-analysis

Gatto

Lansdown

2022

JSES Reviews, Reports, and Techniques

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Statin use and longitudinal changes in quantitative MRI-based biomarkers of thigh muscle quality: data from Osteoarthritis Initiative

Mohajer,

Moradi,

Guermazi

et al. 2023

Skeletal Radiol

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Does statin-treated hyperlipidemia affect rotator cuff healing or muscle fatty infiltration after rotator cuff repair?

Cited by 12 publications

References 41 publications

Biochemical Markers of Aging (Advanced Glycation End Products) and Degeneration Are Increased in Type 3 Rotator Cuff Tendon Stumps With Increased Signal Intensity Changes on MRI

Biochemical Markers of Aging (Advanced Glycation End Products) and Degeneration Are Increased in Type 3 Rotator Cuff Tendon Stumps With Increased Signal Intensity Changes on MRI

Dyslipidemia is associated with risk for rotator cuff repair failure: a systematic review and meta-analysis

Statin use and longitudinal changes in quantitative MRI-based biomarkers of thigh muscle quality: data from Osteoarthritis Initiative

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